Organization
BANNER CLINICAL & PERFORMANCE PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LAURENCE GRIMES PHD LP (LICENSED PSYCHOLOGIST)
(618) 554-2664
Entity
Organization
Contact information
Practice address
2703 N MISSION RD, PEORIA, IL 61604-2343
(618) 554-2664
Mailing address
2703 N MISSION RD, PEORIA, IL 61604-2343
(618) 554-2664
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
04/27/2026
Last updated
04/27/2026
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